HHS issues pandemic planning guide for states

Mar 14, 2008 (CIDRAP News) – The US Department of Health and Human Services (HHS) unveiled a comprehensive pandemic influenza guidance document for states yesterday with the first of three live Web seminars (webinars) designed to assist state officials with planning activities.

Introducing the state guidance were William Raub, PhD, science advisor to HHS Secretary Mike Leavitt, and other officials from federal agencies that have central roles in national pandemic planning. The federal role in assisting the states was spelled out in the Bush administration's national pandemic influenza strategy plan, released by the White House's Homeland Security Council in May 2006. HHS hosted the webinar on the Pandemicflu.gov Web site, where the agency also posted the guidance document and other resources for state planners.

Three overarching goalsThe 132-page state guidance document reflects the input of 14 federal departments and includes suggestions received from several states at five regional meetings that were sponsored by the National Governors Association (NGA).

Guidance materials outline three overarching strategic goals that states plans should address: ensuring continuity of state government and agency operation, protecting citizens, and maintaining critical infrastructure and key assets. Several operating objectives are included in each goal. For example, for maintaining critical infrastructure, states are encouraged to build private-public partnerships and beef up protection and information sharing.

"Pandemic influenza begins as a health issue . . . but it becomes a matter of continuity for the whole society," Raub said.

Christa-Marie Singleton, MD, MPH, associate director for science in the division of state and local readiness at the US Centers for Disease Control and Prevention (CDC), said states, territories, and the District of Columbia are required to submit their pandemic plans to HHS so that the agency can establish a baseline for each state's pandemic preparedness and help each identify gaps in planning. The guidance walks states through each issue to consider and includes details on how to format and submit their plans to the HHS.

Singleton said the federal government might withhold some 2009 funding for states that don't submit their pandemic plans. The guidance document says the plans are due on Jun 16.

Webinar participants said federal officials would be available to help states prepare their pandemic plan submissions. Also, HHS will host two more webinars on state pandemic planning, on Apr 2 and Apr 30.

Chris Logan, program director in the NGA's homeland security and technology division, participated in yesterday's HHS webinar. He told CIDRAP News that he hadn't had a chance to read the entire document, but he lauded the government's work on the state guidance.

"To their credit, they reached out to states pretty significantly. In our workshops, they took a lot of input," he said.

Governors' group cites progress, gapsMeanwhile, a recent NGA report says states have already made much progress toward pandemic preparations, but they have voiced concern about several gaps. The report is an interim assessment from the NGA's first five regional workshops on pandemic planning, which included representatives from 27 states and territories.

According to the report, participants could describe the complex nature of a pandemic and the challenges states would face. State officials could also predict possible disruptions in education and public safety and what the role of the National Guard would be. They could also identify what areas of state economies would be affected.

However, the report found several gaps and shortcomings in how states would respond to and recover from a pandemic. For example, on the topic of school closures, states haven't adequately considered how the measure would affect other states, and there is no consensus among states on how to communicate with the public.

States are unclear about what federal resources would be available during a pandemic and what triggers would prompt the federal government to assume certain roles and responsibilities, the report said.

Feedback from the workshops revealed that state plans rely heavily on privately held infrastructure, volunteer networks, and other organizations that are outside state control. However, the report states that most state plans don't define the roles and responsibilities of these groups.

Officials from various states were aware of potential shortages of critical goods and services during a pandemic, but they have not developed solutions and coordination with the private sector to ensure the availability of key products across state and national borders.

Logan said the NGA would publish a final assessment report on state pandemic preparedness after all 10 regional workshops are completed.